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Highest ambulatory speed using Lokomat gait training for individuals with a motor-complete spinal cord injury: a clinical pilot study

  • Original Article - Spine trauma
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Abstract

Background

Motor impairment and loss of ambulatory function are major consequences of a spinal cord injury (SCI). Exoskeletons are robotic devices that allow SCI patients with limited ambulatory function to walk. The mean walking speed of SCI patients using an exoskeleton is low: 0.26 m/s. Moreover, literature shows that a minimum speed of 0.59 m/s is required to replace wheelchairs in the community.

Objective

To investigate the highest ambulatory speed for SCI patients in a Lokomat.

Methods

This clinical pilot study took place in the Rehabilitation Center Kladruby, in Kladruby (Czech Republic). Six persons with motor-complete sub-acute SCI were recruited. Measurements were taken at baseline and directly after a 30 min Lokomat training. The highest achieved walking speed, vital parameters (respiratory frequency, heart rate, and blood pressure), visual analog scale for pain, and modified Ashworth scale for spasticity were recorded for each person.

Results

The highest reached walking speed in the Lokomat was on average 0.63 m/s (SD 0.03 m/s). No negative effects on the vital parameters, pain, or spasticity were observed. A significant decrease in pain after the Lokomat training was observed: 95% CI [0.336, 1.664] (p = 0.012).

Conclusion

This study shows that it is possible for motor-complete SCI individuals to ambulate faster on a Lokomat (on average 0.63 m/s) than what is currently possible with over-ground exoskeletons. No negative effects were observed while ambulating on a Lokomat. Further research investigating walking speed in exoskeletons after SCI is recommended.

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Abbreviations

SCI:

Spinal cord injury

VAS:

Visual analog scale

SD:

Standard deviation

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Author information

Authors and Affiliations

  1. Department of Surgery, Radboudumc, Nijmegen, the Netherlands

    Lysanne van Silfhout

  2. Rehabilitation Centre Kladruby, Kladruby, Czech Republic

    Zdenĕk Váňa

  3. Department of Trauma Surgery, Radboudumc, Nijmegen, the Netherlands

    Michael J. R. Edwards

  4. Department of Neurosurgery, Radboudumc, Nijmegen, the Netherlands

    Ronald H. M. A. Bartels

  5. Department of Rehabilitation, Radboudumc, Nijmegen, the Netherlands

    Henk van de Meent

  6. Department of Orthopedic Surgery, Radboudumc, Nijmegen, the Netherlands

    Allard J. F. Hosman

  7. Third Faculty of Medicine, Neurosciences, Charles University, Prague, Czech Republic

    Jakub Pĕtioký

Authors
  1. Lysanne van Silfhout
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  2. Zdenĕk Váňa
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  3. Jakub Pĕtioký
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  4. Michael J. R. Edwards
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  5. Ronald H. M. A. Bartels
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  6. Henk van de Meent
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  7. Allard J. F. Hosman
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Contributions

LvS was involved in the study concept and design, analysis and interpretation of the data, drafting the manuscript, and revising the final manuscript. JP and ZV were involved in the acquisition of data and critical revision of the manuscript. AH and HvdM were involved in the study design, data analysis and interpretation, and critical revision of the manuscript. ME and RB were involved in the data analysis and interpretation, and drafting and revising the manuscript.

Corresponding author

Correspondence to Lysanne van Silfhout.

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Competing interests

The authors declare that they have no competing interests.

Ethics approval and consent to participate

Approval of the local ethics committee was obtained for this study, and informed consent was obtained from the participants of this study.

Availability of data and material

All data generated and analyzed during this study are available from the corresponding author on reasonable request.

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This article is part of the Topical Collection on Spine trauma

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van Silfhout, L., Váňa, Z., Pĕtioký, J. et al. Highest ambulatory speed using Lokomat gait training for individuals with a motor-complete spinal cord injury: a clinical pilot study. Acta Neurochir 162, 951–956 (2020). https://doi.org/10.1007/s00701-019-04189-5

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  • DOI: https://doi.org/10.1007/s00701-019-04189-5

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